HomeMy WebLinkAbout03-02-07
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REV .1500 EX + (6~Ol
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
,;f->- :',L USE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17126-0601
FILE NUMBER
21
06
00430
NUMBER
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[DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
,BARBOUR, ORIOLA MAE
I DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
i 05/09/2006 ! 07/10/1922
:(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL)
COUNTY CODE . YEAR
SOCIAL SECURITY NUMBER
189-18-5324
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
~ 1. Original Return 0 2. Supplemental Return
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I- 0 0 4a. Future Interest Compromise (date of death after
>::~Ul 4. Limited Estate
(j0::>:: 12-12-82)
w",-(j ~ 0
,,00 6. Decedent Died Testate (Attach copy 7. Decedent Maintained a Living Trust (Attach
(j0::-'
",-m of Will) copy of Tnust)
"'-
<l: 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between
1 5
8. Total Number of Safe Deposit Boxes
o 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
AME
!z i Lisa Marie Coyne
~ FIRM NAME (If applicable)
~ i Coyne & Coyne, P.c.
JELEPHONE NUMBER
I 717/737 -0464
I COMPLETE MAILING ADDRESS
3901 Market Street
Camp Hill, PA 17011-4227
(1 ) None
(2) None
(3) None'
(4) None
(5) 43,678.09
(6) None
(7) None
(8)
(9) 6,460.60
---~~----
(10) 4,107.89
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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. . 3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
r,,)
43,678.09
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11 ) 10,568.49
(12) 33,109.60
- _._--_._._-----~-
(13) 4,367.81
(14) 28,741.79
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
;::
<l:
I-
::> (17)
"'- 17.Amount of Line 14 taxable at sibling rate x .12
::;;
0 ------~_.~~
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>< 18. Amount of Line 14 taxable at collateral rate
<l: 28,741.79 x .15 (18) 4,311.27
I-
19. Tax Due (19) 4,311.27
20. ~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
02
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC. I
PERSONAL PROPERTY
J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
- ~
------
ESTATE OF
BARBOUR, ORIOLA MAE
FILE NUMBER
21 - 06 - 00430
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
VALUE AT DATE OF
DEATH
.------
34,270.12
ITEM
NUMBER
1
DESCRIPTION
ACNB Checking Account No. 0600555
2
ACNB Savings Account No. 9076069
8,431.97
3
Various Jewelry Pieces -- Sold for Scrap Gold
600.00
4
Various Jewelry Pieces -- Per Attached Inventory
376.00
TOTAL (Also enter on Line 5, Recapitulation)
43,678.09
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JOSEpli JAMES JEWELERS
TO WHOM IT MAY CONCERN:
This is to certify that we are engaged in the jewelry business, appraising diamonds, watches, jewelry and precious stones of all descriptions We herewith certify that we have this day carefully
examined the following listed and described articles, the property of:
NAME:
ADDRESS:
Ross Kennedy c/o estate of Oriola M. Barbour
1710 Josiah Chowning Way
New Cumberland, PA 17070
We estimate the value as listed for insurance or other purposes at the current retail value, excluding Federal and other taxes. In making this Appraisal we DO NOT agree to purchase or replace
the articles
DESCRIPTION
The following items are appraised for estate purposes
Lady's strand of cultured pearls. Each of the eighty-nine cultured pearls measures approximately
6-6.25mm in diameter. Each pearl is well matched in color, moderate luster, and with few eye visible blemishes.
The Mikimoto stamp is present on the "silver" clasp with a 4mm.pearl attached. The strand measures approximately
25 inches long. . / '.
Value: 340.00.~.
,_'_'I;.:;f}...",::~~#"r?;"..
The remaining twenty-nine items of the estate were aged costume jewelry (bracelets, earrings,
rings). The metals include silver and gold plated base metals, enamel over base metal, and a few plastic items.
These items are not marketable through a jewelry or retail establishment. If these items were offered on an on-line
intemet auction, the entire twenty-nine piece lot may value at approximately $36.00-$50.00.
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sD.DAVISP.G.
August 25,2006
The foregoing Appraisal is made with the understanding that the Appraiser assumes no liability with respect to any action that may be taken on the basis of this Appraisal
301 East Main Street · Mechanicsburg, PA 17055 · (717) 795-9224
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10
11
12
RECEIVED By
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KEEP THIS SLIp FOR REFERENCE
~ ADAMS COUNlY
NATIONAL BANK
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May 17,2006
Coyne & Coyne
Attorneys at Law
3901 Market Street
Camp Hill, PA 17011
Re: Estate of Oriola M. Barbour
Dear Ms. Coyne:
The following information is being provided as per your request:
Acct. Type Account Account Accrued Ownership Date
No. Principal on Interest to Opened
D.O.D. D.O.D.
Checking 0600555 $34,270.12 $00.00 Individual 4-1-87
Savings 9076069 $8,427.29 $4.68 Indi vidual 1-1-92
Inquiries concerning ACNE Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5116.
Sincerely,
11 O-V0 h &rnv--
,
Lois Kime
Deposit Services
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
___L_
I FILE NU-MBER --- --
I~- 06 - 00439
ESTATE OF BARBOUR ORIOLA MAE
,
ITEM
NUMBER
A.
B.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Dugan Funeral Home, Inc.
100.00
2.
Reception
200.00
ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Ross E. Kennedy
Social Security Number(s) I EIN Number of Personal Representative(s):
192-34-0484
Street Address 1710 Josiah Chowning Way
City New Cumberland State P A
Year(s) Commission paid 2007
2,160.00
Zip 17070
2.
Attorney's Fees Coyne & Coyne, P.c.
3,000.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills
136.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Postage 39.00
2 Legal Advertisement-- Patriot News 103.65
Total of Continuation Schedule(s)
721.95
TOTAL (Also enter on line 9, Recapitulation)
6,460.60
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF BARBOUR, ORIOLA MAE
3
Schedule H
Funernl Expenses &
Adninislralive Cos1s cootinued
Legal Advertisement-- Cumberland Law Journal
4
Estate Checks
5
Reserves
6
Mileage for Executor
7
Toll Calls for Executor
8
Joseph James Jewelers-- Appraisal Fee
9
Postage and Certified Mailings
10
Filing Fee-- Inheritance Tax Return
I FILE NUMBER
21 - 06 - 00430
Page 2 of Schedule H
75.00
13.95
300.00
240.00
15.00
53.00
10.00
15.00
'*
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
---~---
ESTATE OF
BARBOUR, ORIOLA MAE
Include unreimbursed medical expenses.
ITEM
NUMBER
1 West Shore Rehab
DESCRIPTION
2
Pharmerica
3
Mobile X-Ray Imaging
4
Caremark
FILE NUMBER
21 - 06 - 00430
TOTAL (Also enter on Line 10, Recapitulation)
AMOUNT
3,617.92
421.95
33.02
35.00
4,107.89
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BARBOUR, ORIOLA MAE
FILE NUMBER
21 - 06 - 00430
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
RELATIONSHIP TO
DECEDENT
~ Do Not List Jl'Ustee(s)__~_~~,___
AMOUNT OR SHARE
OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Larry K. Kennedy
Nephew
1/4 of Residual
2
Ross E. Kennedy
Nephew
1/4 of Residual
3
Kelly 1. Kennedy
Grand-Niece
1/4 of Residual
4
Thomas P. Kennedy
Grand-Nephew
1/4 of Residual
II.
i
I Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~t
NON-TAXABLE DISTRIBUTIONS:
IA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
. BEING MADE
1.
iB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
. ldaville United Bretheran Church (10% of Estate)
I
I
4,367.81
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
4,367.81
..------...---....-~-,.-~-~--~-.-,,---~-~~"-=~:~"-;;,~.:::."--:.:i}-~~;i=:o"'ti?;;.F;:;:.;
]La~t DiU anb. tlrt~tamtnt
of
Q&riola :ffl:. ~arbour
I, Oriola M. Barbour, of Straban Township, Adams County, Pennsyivania, declare this
to be my Last Will and rFoke any Will previously made by me.
ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, shall be paid from my residuary estate as soon as
practicable after my decease as a part of the expense of the adm inistration of my estate,
ITEM II: I bequeath ten percent (10%) of my estate to the Idaville United Brethren
Church, Idavillc, Pennsylvania, to be used for general purposes,
ITEM III: I bequeath my ruby ring with a yellow gold setting, (originally belonging to
my brother-in-law, D, C. Kennedy), to my grandnephew, Thomas p, Kennedy,
ITEM IV: I devise and bequeath: the residue of my estate of every nature and wherever
situate, in equal shares to my nephews, Larry K. Kennedy and Ross E, Kennedy; my
grandniece, Kelly], Kennedy; and my grandnephew, Thomas p, Kennedy, If any named
beneficiary is notthe living, his or her share shall be distributed equally to the remaining then-
living named beneficiaries.
ITEM V: I appoint Adams County National Bank, of Gettysburg, Pennsylvania,
guardian of any property which passes, either imder this will or otherwise, to a minor and with
respect to which I am authorized to appoint a guardian and have not otherwise specifically
done so, provided that this appointment of a guardian shall not supersede the right of any
fiduciary in its discretion to distribute a share where possible to the minor or to another for the
minor's benefit. Such guardian shall have the power to use principal as well as income from
time to tim~ for the minor's support and education (including college education, both graduate
and undergraduate) without 'regard to his or her parent's ability to provide for such support and
education, or to make payment for these purposes, without further responsibility, to the minor
JOHN w. PHIl-LIPS
ATTORNEY AT L~AW
101 WEST MIOl)LE; STREET
GET'TY$IiIURG. PA 17~~ 5
or to the minor's parent or to any person taking care of the minor.
Ill!
.. __~__~____._.....___._., .o._____.~.__..,______.,_._'_~____.____:----'-- - -~-----------.-------,. .~.-.--._---------~-'-...-------~---
JOHN W. PHILLIPS
ATTORNEY ,0.,1' LAW
101 WE:ST MIDI)LE5TRI.':ET
GETTYSIilURG, Fi'A 17325
ITEM VI: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate
as a part ofthe expense of the administration of my estate.
ITEM VII: r appoint my nephew, Ross E. Kennedy, executor of this my last will.
Should my nephew, Ross E. Kennedy, fail to qualify or cease to act as executor, I appoint my
nephew, Larry K. Kennedy, executor of this my last will.
ITEM VIII: I direct that my executor and guardian or their successors shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this_# day of
~~,2004.
1/ dx.) /:h ;hw/;~
Oriola M. Barbour
The preceding instrument, consisting of
this and one other typewritten page, each.
identified by the signature of the Testatrix,
was on the day and date thereof signed,
published and declared by Oriola M. Barbour,
the Testatrix therein named, as and for her
Last Will, in the presence of us, who at her
request, in her presence and in the presence
of each other, have subscribed our names as
witnesses hereto.
2
STATE OF PENNSYLVANIA,
COUNTY OF ADAMS.
We, Oriola M. Barbour,
~'LLIPS
JOHN vV. H-tILLIP5 , andJ~i3IE E.
, the testatrix and the witnesses, respectively, whose names are signed
to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the testatrix signed and executed the foregoing instrument as her last
will and testament, and that she had signed willingly, and that she executed it as her free and
voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence
and hearing ofthe testatrix, signed the will as witness and that to the best of their knowledge
the testatrix was at that time eighteen (18) years of age or older, of sound mind and under no
constraint or undue intluence.
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Subscribed, sworn to and acknowledged
before me by Oriola M. Barbour, the
testatrix, and subscribed and sworn to
before me by JOH N W?t-+/I-LI PS
and f2:>V/M'JIE t.. "'PHil Ll ("$ , witnesses,
this ~ day of fVI A1 ,2004.
~/Xf1, J! ~Al
Not. y Public /
My commission expires:
JqrlN w, PHI\.-I.IPS
ATT9Rr'i~Y AT LAW
101 W~ST MIQQLE'STREET
GE'f'TYS8URG PA 17~25
Decedent's Complete Address:
STREET ADDRESS
I STATE PA
I ZIP 17011
J
770 Poplar Church Road
CITY
Camp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
4,311.27
4,200.00
215.56
Total Credits (A + B + C)
(2) 4,415.56
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
Total Interest/Penalty (0 + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE.
(3)
(4)
0.00
104.29
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE.
(5)
(5A)
(5B)
0.00
5.
A. Enter the interest on the tax due.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or inco~e of the property transferred;.................................:............................................ B ~
b. retain the nght to designate who shall use the property transferred or ItS Income;................................ ~
c. retain a reversionary interest; or............................._............................................................................. 0 ~
d. receive the promise for life of either payments, benefits or care?........................................................... 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?........................... ............................... ............ ..... ............. .n..................... 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?..........................................................................................n.................... 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I have examined this return. including accompanying schedules and statements. and to the best of my knowledge and belief. it is true, con'eel and complete. Declaration
preparer other than the personal representative is based on all information of which preparer has any knowledge. .----.-~~--~-_..-
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
Ross E. Kennedy
xC:. rI_"-<,!-<7/ ',- .<> A
SIGNATURE OF PERSON RESPONSIBLE FOR FILlN RETURN
1710 Josiah Chowning Way
New Cumberland, PA 17070
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fD:qEt
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Lisa Marie Coyne
ADDRESS
DATE
3901 Market Street
Camp Hill, PA 17011-4227
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 39116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 39116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 39116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 39116
1.2) [72 P.S. 39116 (a) (1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption..
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COYNE & COYNE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
Henry F. Coyne
Lisa Marie Coyne
3901 Market Street
Camp Hill, Pennsylvania
17011-4227
717-737-04(;4
Fax: 717-737-51()1
March 1, 2007
Office of Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PAl 70 13
Re: The Estate of Oriola M. Barbour, Deceased
No. 21-06-0430
Dear Sir or Madam:
We represent the Estate ofthe Late Oriola M. Barbour.
Enclosed are an original and two copies of the Inheritance Tax Return for this Estate. Kindly
docket the original and return to me one "clocked-in" copy with the enclosed, stamped envelope. I all so
enclose check no. 116 in the amount of $15.00 for the filing fee. Kindly docket payment and issue a
receipt for the filing fee.
Thank you for your assistance.
Very truly yours,
LMC/amd
Encls.
~E & COYNE, P.c.
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r,tisa Mprie Coyne 'J.
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cc: Mr. Ross E. Kennedy, Executor
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